Public Policy Weekly Clips: August 8, 2016

August 8, 2016 · Paul Cotton

NCQA gives a rundown of the best national, state and private sector health care articles from the week. Here are our picks for today’s Public Policy Weekly Clips.



Sites for the PCMH CPC+ demonstration include 7 not in the original CPC initiative—for a total of 14 states/regions.

Readmissions penalties will again hit over half of hospitals & be about 1/5th higher than last year.

Just 18% of hospitals consistently assess patient-reported outcomes, but the rest intend to start soon.

NCHC’s John Rother ID’ed steps to accelerate Medicare delivery system transformation.

Outpatient hospital services, not drugs, are the leading driver of ACA premium increases.

Average ACA annual premium totals in 2016 are $617 lower than CBO projected they would be.

Aetna cancelled its ACA expansion to more states & is reassessing states where it currently has offerings.

Aetna is notifying doctors whose opioid prescribing habits are outside of the norm.

Aetna & Humana are selling  Medicare Advantage plans in 21 states to Molina to help ease opposition to their merger.

PhRMA is planning a post-election counterattack against criticism over high drug prices.

Drug firms funded 75% of consumer groups opposing CMS’ Part B value-based pricing demonstration.

Drug firms are working to get animal farmers to use vaccines instead of antibiotics to fight resistance.

PBM formularies will exclude more drugs next year in an effort to hold costs down.

GAO wants drug makers to submit Part B sales price data & source documentation for verification.

A simple hearing test may help ID children at risk for autism before they’re old enough to speak.

The VA is trying to use patient-reported health status measures to improve the value of elective PCI.

Just 5-8% of seniors get prescriptions or talk with doctors online; 16% search for health info online.

The average American is 15 pounds heavier now than 20 years ago.

Prevalence of chronic kidney disease has remained stable since 2004.

High animal protein intake is linked to higher mortality; high plant protein intake appears to lower it.

87% of Medicaid enrollees are satisfied with benefits & coverage; 83% are satisfied with doctor access.

Former NQF head Christine Cassel has received the 2016 Gail L. Warden Leadership Excellence Award.




CMS issued guidance to states on strengthening home-based care for disabled Medicaid enrollees.

NGA issued a step-by-step guide for states seeking major Medicaid changes, such as waivers.

Colorado Medicaid’s strict limits on costly hepatitis C drugs are under fire for increasing disparities.

Illinois consumer advocates are fighting ACA insurers’ proposed premium hikes of up to 45%.

Indiana’s plan to lock out Medicaid enrollees for 6 months if they do not renew their eligibility was blocked by CMS.

Kentucky is delaying its Medicaid waiver application after getting strong opposition.

Massachusetts & New Mexico ACA co-ops joined the list of those suing over risk adjustment payments.

Michigan ACA plans are request premium increases that average 17.3%.

New Hampshire Medicaid director Katie Dunn is stepping down after over 10 years on the job.

New York reduced ACA insurers proposed rate hikes by 28% on average.

Ohio will pay bonuses to primary care clinicians for PCMH care coordination & extended office hours.

Pennsylvania ACA plans’ proposed premium hikes of up to 48% are generating stakeholder opposition.

Virginia’s Bureau of Insurance is opposing the Anthem-Cigna merger.




Nurses & doctors are fighting back against corporate healthcare by unionizing.

In 2012, increasing costs led roughly half of American families to cut back on medical care.

EBRI says HSAs are increasingly critical as the average retiring couple will need nearly $300K.

Over 1 in 6 employers say rising health costs are affecting their company’s retirement plan decisions.

There are no health care finance decisions that a majority of Americans don’t find challenging.

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